| Popis: |
There are numerous focal neurological conditions that share symptoms with, or can mimic the appearance of, depression but are a result of discrete and identifiable neuropathology. In these cases, identification of symptomatology that would be atypical in idiopathic major depressive disorder is crucial for differentiation of these conditions. In some instances, recognition of atypical signs and symptoms prompt neurological and medical evaluation which may result in very different directions in symptom and disease management. Similarly, treatment options may differ between these syndromes and idiopathic depression. In the case of known brain injury, attention to affective changes without subjective reports of depressed mood or anhedonia may suggest damage to frontal-subcortical circuits which can result in abulia and alexithymia which should be differentiated from depression. In some instances, depression may also be comorbid with these symptoms. This is the case of a young man who suffered bilateral globus pallidus damage in the setting of anoxic brain injury due to drug overdose. Globus pallidus, part of the basal ganglia, is part of the cortico-striato-thalamocortical loops which are crucial in motor, emotional, and neurocognitive function. This case typifies the multidisciplinary and complex diagnostic attention and treatment involved in management of neurological syndromes which can overlap with depressive illness. |
